Psychotherapy In Your Doctor’s Office

One of the trends that isn’t likely to change significantly much is the fact that most people talk to their primary care doctor or family physician about a mental health problem first. Your family doctor is seen as the expert in all things, even when those things include mental health issues or concerns.

So how effective are brief psychotherapy interventions conducted in a primary care setting? Researchers (Cape et al., 2010) looked at the results of 34 studies involving 3,962 patients and found the answer — therapy in a doctor’s office is surprisingly effective.

Cognitive-behavioral therapy for anxiety had the most powerful effect size, meaning it’s likely the most effective brief intervention for anxiety disorders. General counseling and problem solving therapy were also effective, but to a lesser extent. All forms of therapy showed effectiveness for depression, anxiety and mixed depression/anxiety in patients.

The researchers defined, for the purposes of this study, “brief psychotherapy” to be anywhere between 2 and 10 sessions. For some therapists, this may even seem a bit long — 10 sessions is a lot of time to work on a single, specific mental health concern.

It’s important to note that while the researchers refer to the psychotherapy treatment being conducted in a “primary care” setting, it was not conducted by the family doctor. The therapy was conducted by experienced therapists and psychologists — not physicians.

While all forms of brief therapy studied were shown to be effective for these three problem areas, they were far less effective compared to longer-length psychotherapy treatments. This is no surprise, given that the tools and skills taught in therapy can be best learned in an environment where a person can try something new, and come back the following week to discuss and gain feedback from the therapist. Longer-term psychotherapy remains the best treatment (often in combination with medications), but “longer-term” for this study meant between 12 and 24 sessions (typically 3 to 6 months).

These research findings should come as no surprise to therapists, however. Many therapists and psychologists are aware that some patients (some studies put the number as high as one in two) come in for less than 3 sessions. There are even books devoted to this phenomenon, called single-session psychotherapy. The fact is, brief interventions are necessary because people often don’t want anything more in-depth or longer.

The good news is that brief (2 – 10 sessions) psychotherapy interventions can be effective. You don’t necessarily need long-term therapy to feel better from depression or anxiety.

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About John M. Grohol, Psy.D.

Dr. John Grohol is the founder & CEO of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member and treasurer of the Society for Participatory Medicine.